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Res Involv Engagem. 2018 Feb 5;4:4. doi: 10.1186/s40900-018-0086-2. eCollection 2018.

A method for co-creation of an evidence-based patient workbook to address alcohol use when quitting smoking in primary care: a case study.

Author information

1Centre for Addiction and Mental Health, 100 Stokes St, Toronto, ON M6J1H4 Canada.
2Institute for Clinical Evaluative Sciences, Toronto, Ontario Canada.
3Department of Family and Community Medicine, Psychiatry, University of Toronto, Toronto, Canada.


Plain English summary:

The purpose of this paper is to describe a patient engagement event designed to create an educational workbook with smokers who drink alcohol at harmful levels. The goal was to create a workbook that combined scientific evidence with patients' values, preferences, and needs. Fourteen adult smokers who drink alcohol were invited to the Centre for Addiction and Mental Health (CAMH) to take part in a four-hour event to help design the workbook with the CAMH research team. Participants provided their opinions and ideas to create an outline for the workbook, including activities, images, and titles. The workbook - called Self-Awareness - is currently being offered in a smoking cessation program in 221 primary care clinics across Ontario to help smokers quit or reduce their harmful alcohol use. The patient engagement event was a useful way to co-create educational materials that incorporate both scientific research and patient needs.


Background Evidence-based medicine is the integration of best research evidence with clinical expertise and patient values. There are few methodologies on how to design evidence-based programs and resources to include patient values. The latter is an important aspect of patient-centered care, and is essential for patients to trust the recommendations and empower them as consumers to make informed choices. This manuscript describes a participatory research approach to design patient-facing educational materials that incorporate both evidence-based and community-sensitive principles. These materials are intended to support smokers to reduce or stop harmful alcohol consumption. Methods Adult smokers who report consuming alcohol were invited to a co-creation meeting at the Centre for Addiction and Mental Health's Nicotine Dependence Service to guide the adaptation of evidence-based materials. The four-hour event consisted of individual reflections, group discussions, and consensus-building interactions. Detailed notes were taken and then incorporated into the material. Results Fourteen individuals participated in the event. The end product was a descriptive outline of an educational resource - entitled Self-Awareness - incorporating material from evidence-based workbooks and patient-driven features. Participants collaboratively selected the resource's content, structure, and titles. Conclusions This model describes a participatory research method that emphasizes the value of the patient perspective; preliminary evidence finds this adaptation approach can increase the adoption of resources. The process described in this article could be replicated in other settings to co-create evidence-based resources, interventions, and programs that reflect the needs of the community. Trial registration NCT03108144. Retrospectively registered 11 April 2017.


Alcohol; Co-creation; Community-sensitive; Educational resources; Evidence-based medicine; Participatory research; Patient engagement; Tobacco

Conflict of interest statement

The study was reviewed by the research ethics board at the Centre for Addiction and Mental Health (approval number: 035–2015). Patient consent for participation was obtained prior to the engagement event.Not Applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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